IRRATIONAL USE OF DRUGS AND THEIR EFFECT BY HEALTH CARE PROVIDERS AND THE POPULACE

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IRRATIONAL USE OF DRUGS AND THEIR EFFECT BY HEALTH CARE PROVIDERS AND THE POPULACE

CHAPTER ONE

INTRODUCTION

1.1 Background of the study

Rational use of medicines requires that “patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community”. Irrational or non-rational use is therefore the use of medicines in a way that is not compliant with rational use as defined above. Aspects of irrational medicine use are found in diagnosis which includes (inadequate examination of patient, incomplete communication between patient and doctor, lack of documented medical history, inadequate laboratory resources); prescribing which includes extravagant prescribing, over-prescribing, incorrect prescribing, under-prescribing and multiple prescribing); dispensing which includes (incorrect interpretation of the prescription, retrieval of wrong ingredients, inaccurate counting, compounding, or pouring, inadequate labelling, unsanitary procedures, packaging, poor-quality packaging materials, odd package size, which may require repackaging and unappealing package) and patient adherence which includes (poor labelling, inadequate verbal instructions, inadequate counselling to encourage adherence, inadequate follow-up/support of patients, treatments or instructions that do not consider the patient’s beliefs, environment, or culture.

Evidence from Kazakhstan shows that there is increasing trend in use of expensive, widely advertised, brand name medications, and reduction in the use of generic first line medications thus leading to adverse health and economic effects. The effects of irrational use of medicines include fast development of resistance, treatment failure, high incidence of toxicities, poor health outcomes and increased health care costs. A study in Nepal of primary health care centers showed that 20%–52% of drug costs were wasted through irrational prescribing. The wastage was incurred by formally trained health workers and it is expected to be worse with PMDs who have no formal training on treatment of common ailments. Studies have shown that these practices could be improved through a combination of different approaches such as training and capacity building

Studies of irrational medicine use have focused on formal healthcare facilities and with clinicians or formal health care workers, but little has been done in the informal health care facilities. And over the years little or no attention has been focused on the cost of irrational medicine use especially in the informal healthcare facilities.

1.2 Statement of the problem

There is paucity of information in Nigeria on the economic costs associated with inadequate medicine dispensing for childhood illnesses by PMDs. Information on this is therefore needed especially against the background that irrational use could have great impact on the household income where a large proportion of a family’s out-of-pocket expenditures on health care is on drugs

Objectives of the study
To understand the impact of irrational use of drugs by health care providers on public health
To understand the relationship between irrational use of drugs by health care providers and public health development status.

Research questions
What is the impact of irrational use of drugs by health care providers on public health
What is the relationship between irrational use of drugs by health care providers and public health development status.